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YeePei Song 🕷💙
3.3K posts
YeePei Song 🕷💙
@syeepei
🇲🇾🇬🇧 Consultant clinical oncologist. Prostate and bladder cancers. Brachytherapy. NHS and private. Views my own.
Manchester, England Katılım Aralık 2016
716 Takip Edilen1.1K Takipçiler
Significant unmet needs with #NMIBC. BCG is the cornerstone but can be problematic. Clearly a need to explore different treatment options. #clinicaltrials required.
Patients not keen for RC. So how about some RT? #wehaveatrial #getitopened
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Learning about #NMIBC at #SIU2025Edinburgh @SIU_urology from @ParamMariappan. Not a group of patient that ClinOncs like myself traditionally see. But things may change… #clinicaltrials
#improvingoutcomes
#exploreothertreatments
#considerRT
#theTRAINisready
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@bmj_latest @tomroques Discussing straightforward cases not good use of resources and take away from the complex ones who will benefit for more in depth discussions. Current model not sustainable. MDTs have pros and cons, not least preventing rogue practice … does need a revamp.
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The weekly cancer MDT meeting can cause treatment delays, result in poor quality decisions, and waste clinicians’ time, say @tomroques and colleagues.
It’s time for a fresh approach
bmj.com/content/391/bm…
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YeePei Song 🕷💙 retweetledi
@syeepei @SIU_urology @achoud72 And patient choice. Were they offered a choice initially and true shared decision making exploring wishes and preferences or just given one option & subsequent regret. Sadly patient surverys show its the latter @WorldBladderCan @BladderCancerUK
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Off on a short visit to Edinburgh for #SIU2025Edinburgh @SIU_urology to speak about adj RT in #bladderca.
🤔 Can I change the title to “zap zap after making a poor choice” and conclude with “just leave it inside”?
#whydyatakeitout
#tongueincheek
@achoud72 @AlisonBirtle
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YeePei Song 🕷💙 retweetledi
@niyatilobo @SWilliams_MD Really interesting as most data published so far didnt take into account cost of robotics+ nac pre RC.
And of course there is patient cost in the trade of on sexual functions and body image as weve seen from multiple propensity matched analyses, qabc study and spare qol data.
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@cpeedell @DrewMoghanaki Not a lung oncologist so my comment not specific to lung cancer. In a much broader sense, does anyone else find the fascination with expensive drugs over the cheaper, less fancy radiotherapy treatments worrying? 🧐
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@DrewMoghanaki The non-curative actor here is chemotherapy. Immunotherapy is curing stage IV disease (10-20%), so will cure some stage III disease too. However, a significant proportion of NSCLC doesn’t respond to IO. This trial was unethical and flawed.
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We’ve seen this movie before over the past 2 decades. Trying to replace curative (RT) treatment with non-curative drugs. It’s never ended well, at least not yet.
Gerry Hanna@gerryhanna
No wonder the public have misconceptions about radiotherapy when you see a paper title such as this in @TheLancetOncol Shouldn’t it be Chemo-immunotherapy alone or without surgery or radiotherapy? #radonc
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@gerryhanna @docpriyamvada @TheLancetOncol @DrewMoghanaki @finn_corinne @cpeedell @Mat_Guc @gwalls89 @HegiFiona @_ShankarSiva @MP_MacManus @drdavidpalma How did this title get through the editorial process? @TheLancetOncol are you serious???
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No wonder the public have misconceptions about radiotherapy when you see a paper title such as this in @TheLancetOncol
Shouldn’t it be Chemo-immunotherapy alone or without surgery or radiotherapy?
#radonc
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YeePei Song 🕷💙 retweetledi
@daviesbj Its a modest follow-up and with toxicity.
Excitement yes but let's remember that chenorad offers per rates of 87 percent.
@achoud72 @syeepei @robert_huddart @Prof_Nick_James
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@achoud72 @AlisonBirtle @Prof_Nick_James @RobertHuddart Don’t forget about the lack of >70% grade 3 TRAEs. 🤣🤪.
(Maybe cheaper things are less attractive. I am guilty of loving expensive handbags.)
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👏🏽 BUT #RT leads to more than 80% local control with #CR with modern technology. This is pretty consistent & we know all about long term side effects. Let's follow the science! @AlisonBirtle @syeepei @Prof_Nick_James @RobertHuddart
Daniel Heng@DrDanielHeng
This is so cool. Imagine a world of 65% pT0 CR rates for muscle invasive bladder cancer. This is for cis ineligible but will there be scope creep? Looking forward to EV304 cis eligible. #esmo25 @OncoAlert #amazing
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Demise of RT in a situation like this would merely be a reflection of people’s fascination with expensive new things… at massive financial and QoL toxicities to patients. Very sad.
Prof Ananya💙 @achoud72.bsky.social@achoud72
It's definitely progress to have treatment options for #MIBC & the results are compelling. Remember follow up is short - lots of censoring in both arms I'm old - been hearing about the demise of #RT in favour of systemic for years & yet...@myESMO #ESMO25
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Love that KEYNOTE905/EV303 results positive and suggests possible brighter future for #bladderca.
But need to keep check on over-enthusiasm.
⚠️Median FU only 25.6mths
⚠️pCR 57.1% lovely, but at cost of 71.3% G3 TRAEs
Lots of potential, but let’s calm down…
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@PBlanchardMD The 57% pCR rate with an expensive and toxic treatment doesn’t seem all that exciting when you compare to what the humble RT + radiosensitisation can achieve.
Love the possibilities, but not too excited at the moment.
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Key question is whether this would allow bladder preservation protocols and not cystectomy.
What is the point of removing 57% of intact bladders? Could we do less to improve patients QoL?
#radonc
Pierre Blanchard, MD@PBlanchardMD
KN905 Very impressive results with neoadjuvant EV-P in cisplatin-ineligible muscle invasive #bladdercancer presented by C Vulsteke at #ESMO25 ✅Improved PFS & OS ✅High path CR rates (57%) ✅No delay in surgery ✅Expected toxicity in this frail population New SOC
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YeePei Song 🕷💙 retweetledi
6/
🚨 ❌ Cribriform/intraductal #ProstateCancer is not safe to monitor
▶️ And for long-term (>10y) prevention of metastasis, multimodality treatment may be necessary (keep reading 👇🏼)
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This is the important stuff. This. Not fancy expensive toxic drugs. It may be #commonsense, but it’s oddly refreshing. Thank you @csoncol
@myESMO #esmo2025
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The best place for clinical academic training for UK ClinOnc trainees!
Prof Ananya💙 @achoud72.bsky.social@achoud72
We have #ClinOnc #ACFs in Manchester. If you are ST2 or above please apply & get in touch. We've got exciting research going on! @MCRCnews @RT_physics @CICEManchester @RCRadiologists nihr.ac.uk/funding/2026-a…
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Does anyone else find the rate of completion of 6 cycles surprising? The low rate does not reflect my clinical practice at all.
@achoud72 @AlisonBirtle
Dra. María Natalia Gandur Quiroga@nataliagandur
🟠 LBA109 – DISCUS: 3 vs 6 cycles of platinum-based chemotherapy before Avelumab maintenance in advanced urothelial carcinoma 👨⚕️ Presented by Dr. Enrique Grande (@drenriquegrande) #ESMO25 @OncoAlert @MedicalwatchHQ ➡️ Phase II DISCUS compared 3 vs 6 cycles of platinum-based chemotherapy (cis/gem or carbo/gem) before Avelumab maintenance in untreated advanced UC. ⚡ N = 267; 133 (3C) vs 134 (6C). ⭐ QoL improved with 3C → +8.5 points (p = 0.016). 💡 OS: 18.9 mo in both arms (HR 1.15; p = 0.56). 👉 PFS: 8.0 vs 9.0 mo (HR 1.05; p = 0.79). ⚠️ Grade 3–4 TRAEs: 11.9% (3C) vs 15.7% (6C). 🔆 Conclusion: Shorter induction (3 cycles) followed by Avelumab maintenance preserves efficacy while improving QoL — supporting treatment de-escalation in advanced UC. @DrChoueiri @MyriamChalabi @myESMO #Berlin 🔗 @montypal @DrDanielHeng @VivekSubbiah @HHammersMD @Uromigos #BladderCancer #Avelumab #DISCUS #GU25 #ESMO25 #Oncology #ClinicalTrials
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YeePei Song 🕷💙 retweetledi
We have #ClinOnc #ACFs in Manchester. If you are ST2 or above please apply & get in touch. We've got exciting research going on! @MCRCnews @RT_physics @CICEManchester @RCRadiologists
nihr.ac.uk/funding/2026-a…
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Let’s have a go at a link again
nhsjobs.com/job/-v7537917?…
YeePei Song 🕷💙@syeepei
🚨We are hiring! Would you like to be part of a dynamic urooncology team in a tertiary cancer centre? Get in touch! @achoud72 @TheChristie @TheChristieNHS Job vacancy: Consultant Clinical Oncologist - GU, The Christie NHS Foundation Trust, Manchester | trac.jobs
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